HomeMy WebLinkAbout0100378 POSHKOSH
ON THE WATER
.lob Address 2461 N MAIN ST
Contractor K KELLY INC
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
Owner SKB CAPITAL CORPORATION
Category 440- Industrial-Interior
Bathtub 12 Shower 0 Ejector/Grind 0 DipWell 0 F Prep Sink 0
Whirlpool 0 Floor Drain 11 Water Softner 0 Drink Ftn 0 Serv Sink 0
Lavatory 12 Lndry Tray 0 LocaIWaste 12 Wait. St. 0 Shamp Sink 0
Toilet 12 Lndry Stndp 0 CIothesWshr 12 Ice Chest 0 FIr/Wst Sink 0
Res. Sink 12 Disposal 12 Bidet 0 Exam Sink 0 Catch Basin 0
Bar Sink 0 Dishwasher 12 Beer Tap 0 Sculry Sink 0 Wash Ftn 0
Water Heater 12 Sump Pump 0 Dent. Oper. 0 Hand Sink 0 Urinal 0
Site Drain 0 Classrm Sink 0 Lab Sink 0 Plaster Sink 0 Standp Rec 0
Roof Drain 0 Breakrm Sink 0 Sterilizer 0 Surgeons Sink 0 Ice Maker 0
No 100378
Create Date 01/23/2003
Plan D2-03-0103-P
Gar Drain
Soda Disp
Coffee Maker
Int Grease Trap
Ext Grease Trap
Use/Nature
of Work
NEW 12 UNIT INTERIOR ONLY
Valuation
Issued By
Sanitary Sewer
Storm Sewer
Water Service
Size Material Type #
$32,400.00 Plan Approval $0.00 Permit Fees
Conn. Type
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
$714.00
Date 03/25/2003
Permit Voided
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address 2057 BELLEVUE ST GREEN BAY WI 54311 - 5619 Telephone Number
877-905-3559/920-46
City of Oshkosh
Inspection Services Division
POBox 1130
Oshkosh, WI 54903-1130
Phone: (920) 236-5050
Fax: (920) 236-5084
ON THE ~VATE~
Plumbing Permit Application
I hereby apply for a permit to do and install the following plumbing on the prm, aises hereinafter described, the work to cora'oma to tire
Wisconsin Stat~ Plumbing Cod~, in th~ performance of which all parties hereto agree to and ar~. bound by said statutes.
· Application(s) and fee(s) can be brought to City Hall, RoOm 205 or mailed to Inspection Settees, PO Box 1128,
Oshkosh WI 54903-1128. Commencing work without permit(s) will result in fees King doubled or $100.00 plus the
normal permit fee, which ever is greater.
OR
lf vou arc Ct Co~tractor partici~atin~ in the Permit Fee Account Swtcm and have adequate_funds, check here
~f ~ou want thi4: pr(~cq$~ed through_3fo_ur account _~[~
['-]Industrial
Number of Fixtures:
Whirlpool
Lavatory
~. Sink
B~ Sink
~C-,as O Elect [] PwrVnt
Floor Drain
Lndry Tray
Lab Sink
Ptasi~r Sink
Ladry SUmdp
Disposal
Dishwasht~
Sump Pun~
Ejector/Grind
Wat~ Softn~r
Local Waste
CIo~Acs Wshr
Bid~
]Beer 'T~
Ciassrm Sink
Su~s Sink
Brcakrm Sink
Dent. (3per. Shamp Siak
Dip Well FLr/Wst Sink
Drink Fin Catch Basin
Wait. St. Wash Fm
lc~ Chest Urinal
Exam S~nk Catr Drain
Scuiry Sink Soda
Hand Sink Coffee Maker
F Prep Sink Ice
$erv Sink ,, , SRe l~iu
lnt'C~'~as~ Trap Roof l~in
F. xt Cnease Trap Standp
Electric Contractor
Use I Nature of Work
'
Storm Sc~ / /
Water Se~ice / ~
OR F-]Electric Installation Verification form attached
(If Replacemem)